Ontario man 'outraged' to find licence stripped after admitting himself to hospital in mental health crisis

Navigating the depths of a mental health crisis in 2021, Austin Smith checked himself into a downtown Toronto psychiatric hospital, a decision that would unknowingly leave him without a driver's licence for years to come.

“I was able to recognize those symptoms and bring myself in,” the Toronto area resident said in an interview Friday. CTV News Toronto has agreed to provide anonymity to Smith, whose surname has been changed due to professional concerns.

Smith was hospitalized at the Centre for Mental Health and Addictions in downtown Toronto for depression and psychosis twice that year – once in the spring, for just under two weeks, and again in December, for just over a month.

In the weeks following, however, Smith says he was met with an unexpected wrinkle in his recovery – a letter from the Ontario government informed him his driver’s licence had been suspended.

“I was outraged,” Smith said.

“I had a job that was dependent on driving and I was absolutely stuck without a vehicle," he added. “Yes, I needed to seek mental health care, but it hadn’t affected my ability to drive."

Ultimately, the suspensions forced him to move from a small town just west of Barrie to the Greater Toronto Area, where transit was more readily available, he says.

It’s been over a year since Smith has been eligible to have his licence reinstated, according to ministry documents reviewed by CTV News Toronto. But he says barriers, such as a lack of a family doctor, have slowed the process to a snail’s pace.

In the meantime, he says he’s been unable to find employment in his industry, landscaping, and is surviving off disability payments.

A spokesperson for the Ministry of Transportation told CTV News Toronto they are unable to comment on specific cases, but underlined that Ontario’s current Medical Reporting System has allowed roads to be among the “safest in North America."

"We intend to keep them that way," a spokesperson for the ministry said in a statement. "Road safety is a shared priority across party lines and we will continue to work with all elected members to keep Ontario’s roads safe."

As it stands, physicians are required to report any patient whose ability to drive may be medically compromised by a psychiatric problem or substance use disorder, among other conditions, to the Ministry of Transportation, sparking an automatic suspension of the driver’s licence once processed.

To get their licence reinstated, individuals must have a doctor provide documentation to the ministry, attesting to their medical stability and ability to operate a vehicle – a requirement can prove challenging in a province where at least one million residents are without a family physician.

The process wasn't always so rigid. In 2018, the Ford government changed the program’s rules substantially. The amendments stripped doctors and public officials of a significant degree of discretion when reporting drivers they thought were unsafe. Now, it is mandatory for the reports to be made even if a physician doesn’t believe there is a tangible risk, and reports prompt automatic suspensions.

Some experts and politicians say the program's recent changes have made it too rigid and vulnerable to overuse, leaving patients like Smith to overcome bureaucratic hurdles as they recover and risking the loss of livelihoods.

‘THE OPPOSITE OF WHAT WE WANT’

On Monday, Independent MPP Michael Mantha introduced Bill 105 to the Ontario legislature, which seeks to soften the requirements for mandatory reporting.

The proposed changes mirror that of British Columbia’s current system – in which patients are only flagged for licence suspension after they have been warned of the danger by a health professional yet continue to do so.

In Mantha’s riding of Algoma-Manitoulin, which encompasses many rural areas, the MPP says a vehicle is more than a privilege, “it’s a lifeline.”

“It brings you to medical appointments, to work, to get groceries, it brings kids to schools, to recreational activities,” he said.

The Ministry of Transportation said in its statement it would do its due diligence to review it at the earliest opportunity.

Dr. David Gratzer, physician and psychiatrist at CAMH, is one of many medical professionals who, by law, are required to flag patients to the Ministry of Transportation.

In an interview with CTV News Toronto, Gratzer said he understands why the program is in place – in many cases, he says the reports operate as intended – but that he too worries if the Ford government’s changes have been detrimental to patients.

“It's important for us as a society to always weigh the risks of certain medical conditions and the ability for people to drive and that includes mental illness,” Gratzer said Monday. "That being said, Ontario has moved in one direction, unfortunately, [...] and it ties the hands of physicians and causes stress to patients.”

For example, “if somebody has an acute psychosis currently, it's a mandatory report at the time of admission,” Gratzer said.

He calls this a misstep – one that has resulted in an “explosion of reporting.”

“A patient might come, stay for a couple of weeks, get so much better with treatment and then leave hospital with no psychotic symptoms,” Gratzer explained. “But the way [the law is] written right now, when they walk into our emergency department and talk about their psychotic thoughts, we should be reporting to the ministry then.”

Gratzer says he worries if this could stop individuals from seeking mental health care “in good will.”

“If some individuals think disclosing all of their symptoms might result in them having their license suspended, will it hold them back? Will they in fact hesitate from seeking care?” Gratzer said. “That's exactly the opposite of what we want.”

The physician said, in his opinion, the program could benefit from a shift from mandatory reporting to allowing more room for professional discretion.

“Just as doctors decide whether or not people are admitted to hospital or whether or not patients start medications, doctors could use their discretion with some guidance as to when people are reported to the ministry,” he said.

Gratzer called for more clarity from the ministry, and for it to collect comprehensive data on reporting, suspensions, and reinstations.

'BALANCE AUTONOMY WITH SAFETY'

On May 18, Smith says he will be assigned a new doctor through Ontario’s Health Care Connect program, after which he hopes to be able to obtain the paperwork needed to reinstate his licence, more than a year after he was eligible.

But the situation has left its mark on him and his trust in Ontario’s mental health-care system has suffered a blow, he says.

“I wasn't taken to hospital by the police. I wasn't taken by an ambulance. I went in myself because I knew I was having these problems,” Smith said. “Since then, I've been very careful as to what I say to doctors and health-care professionals.”

Smith’s sentiments echo those Gratzer said he worries patients will hold.

“I do understand that as a society, we need to keep people safe on the roads, but Ontario’s philosophy here has become report first, ask questions later,” Gratzer said. “And we need to balance out the autonomy of patients with the safety of society.”